The online version of this article (doi:10.1186/cc9279) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
KS drafted the manuscript. KS, HKF, and SMW performed the statistical analyses. PM created the merged database. HKF conceived the study. All authors revised the manuscript for important intellectual content. All authors read and approved the final manuscript.
The length of stay (LOS) in intensive care unit (ICU) nonsurvivors is not often reported, but represents an important indicator of the use of resources. LOS in ICU nonsurvivors may also be a marker of cultural and organizational differences between units. In this study based on the national intensive care registries in Finland, Sweden, and Norway, we aimed to report intensive care mortality and to document resource use as measured by LOS in ICU nonsurvivors.
Registry data from 53,305 ICU patients in 2006 were merged into a single database. ICU nonsurvivors were analyzed with regard to LOS within subgroups by univariate and multivariate analysis (Cox proportional hazards regression).
Vital status at ICU discharge was available for 52,255 patients. Overall ICU mortality was 9.1%. Median LOS of the nonsurvivors was 1.3 days in Finland and Sweden, and 1.9 days in Norway. The shortest LOS of the nonsurvivors was found in patients older than 80 years, emergency medical admissions, and the patients with the highest severity of illness. Multivariate analysis confirmed the longer LOS in Norway when corrected for age group, admission category, sex, and type of hospital. LOS in nonsurvivors was found to be inversely related to the severity of illness, as measured by APACHE II and SAPS II.
Despite cultural, religious, and educational similarities, significant variations occur in the LOS of ICU nonsurvivors among Finland, Norway, and Sweden. Overall, ICU mortality is low in the Scandinavian countries.
Scandinavian Society of Anaesthesiology and Intensive Care Medicine[ http://www.ssai.info/Education/intensive_care.html]
Swedish Intensive Care Registry[ http://www.icuregswe.org]
Intensium Ltd[ http://www.intensium.com/web/english]
Norwegian Intensive Care Registry[ http://www.intensivregister.no]
Boffelli S, Rossi C, Anghileri A, Giardino M, Carnevale L, Messina M, Neri M, Langer M, Bertolini G, Marco A, Arnaldo A, Armando A, Patrizia A, Stefani AB, Davide A, Enrico A, Flavio B, Balata A, Massimo B, Remo B, Arcangelo B, Teresa B, Francesco B, Eduardo B, Giuseppe BU, Maurizio B, Olga BM, Andre B, Angelo B, Daniela BR, et al.: Continuous quality improvement in intensive care medicine: the GiViTI Margherita project: report 2005. Minerva Anestesiol 2006, 72: 419-432. PubMed
Metnitz PG, Moreno RP, Almeida E, Jordan B, Bauer P, Campos RA, Iapichino G, Edbrooke D, Capuzzo M, Le Gall JR: SAPS 3: from evaluation of the patient to evaluation of the intensive care unit, Part 1: objectives, methods and cohort description. Intensive Care Med 2005, 31: 1336-1344. 10.1007/s00134-005-2762-6 PubMedCentralCrossRefPubMed
Wunsch H, Angus DC, Harrison DA, Collange O, Fowler R, Hoste EA, de Keizer NF, Kersten A, Linde-Zwirble WT, Sandiumenge A, Rowan KM: Variation in critical care services across North America and Western Europe. Crit Care Med 2008, 36: 2787-2793. e2781-e2789 10.1097/CCM.0b013e318186aec8 CrossRefPubMed
Reis D, Moreno R, Iapichino G: Nine equivalents of nursing manpower use score (NEMS). Intensive Care Med 1997, 23: 760-765. 10.1007/s001340050406 CrossRef
Vasilevskis EE, Kuzniewicz MW, Cason BA, Lane RK, Dean ML, Clay T, Rennie DJ, Vittinghoff E, Dudley RA: Mortality probability model III and simplified acute physiology score II: assessing their value in predicting length of stay and comparison to APACHE IV. Chest 2009, 136: 89-101. 10.1378/chest.08-2591 PubMedCentralCrossRefPubMed
Woods AW, MacKirdy FN, Livingston BM, Norrie J, Howie JC: Evaluation of predicted and actual length of stay in 22 Scottish intensive care units using the APACHE III system: acute physiology and chronic health evaluation. Anaesthesia 2000, 55: 1058-1065. 10.1046/j.1365-2044.2000.01552.x CrossRefPubMed
Sprung CL, Maia P, Bulow HH, Ricou B, Armaganidis A, Baras M, Wennberg E, Reinhart K, Cohen SL, Fries DR, Nakos G, Thijs LG: The importance of religious affiliation and culture on end-of-life decisions in European intensive care units. Intensive Care Med 2007, 33: 1732-1739. 10.1007/s00134-007-0693-0 CrossRefPubMed
- Variations in the length of stay of intensive care unit nonsurvivors in three scandinavian countries
Sten M Walther
Hans K Flaatten
- BioMed Central
Neu im Fachgebiet AINS
Meistgelesene Bücher aus dem Fachgebiet AINS
Mail Icon II